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The Evo-Eco approach to

Behaviour change

Val Curtis/Robert Aunger/


Helen Trevaskis
The Hygiene Centre, LSHTM

Subjective
norm

Perceived
Behavioural
control
Attitudes
Intention

Behaviour

Health
Psychology

Biases/
Heuristics

Behaviour

Behavioural
Economics

Nudges

Promotion
Product

Industry

Time

Brain

Behaviour
Setting
Object

Evo-Eco Model

design and
testing

formative research

intervene

setting

brain

mass

social

planned

in
community

biological

motivated

household

physical

habitual

Monitoring and evaluation

behaviour

health

How many brains?

Human Motives

Origins

human

Justice

primate

Status

mammal

Affiliate
Nurture Attract
Love Hoard

reptile

Fear Disgust
Hunger
Comfort Lust

body

Create

world

Play

Curiosity

brain

Motives for HWWS


MOTIVE

GOOD CANDIDATE?

Disgust

Yes

Nurture

Yes

Affiliation

Yes

Status

Maybe

Attraction

No

Fear

No

Habit
That is what I do ever
since I was a child, I
remember when I was a
child, they kept telling me
to wash my hands with
water, but they never
mentioned soap.
(Ghana)
Hand washing with soap is
not a habit round here.
(Madagascar)

design and
testing

formative research

intervene

setting

brain

mass

social

planned

in
community

biological

motivated

household

physical

habitual

Monitoring and evaluation

behaviour

health

Pledging
Manners,
norms

Contamination

setting

brain

social

planned

biological

motivated

physical

habitual

Facilities,
Cues

behaviour
Disgust
Nurture
Status
Affiliation

Routine

(Curtis, Danquah, Aunger 2009)

Conception
LSHTM
Project coordination
monitoring, evaluation
St John's Research Institute
Bangalore

Campaign Design, training


and support
Centre of Gravity
Campaign Execution
Mudra Max
Funding
Wellcome, SHARE

Testing motives
nurture

disgust

status

social norms

Nurture
Good Mother Vs Bad Mother

Disgust

Habit cues

Routine

intervene

setting

brain

mass

social

planned

in
community

biological

motivated

household

physical

habitual

Monitoring and evaluation

behaviour

health

Figure 2. Handwashing with soap pre and post-intervention by study arm.

35%
30%

Soap use at key events

handwashing with soap

(after toilet, after cleaning child, before eating / food handling)


25%
19%

20%
intervention

15%

Difference 16%
p= 0.005

10%
control
5%

2%
1%

4%

0%
Pre-intervention

Post-intervention

View

Intervention

Control

HWWs is good manners

84%

21%

HWWS protects children

63%

2%

HWWS leads to success in life

30%

0%

Everybody around here


WHWS

35%

8%

HC BC:

Evo-EcoTheory
Evidence as to what works

FR:
What?
Who?
Why?
How?
Creative execution

Lessons

Drivers similar around the


world, but context differs
Behaviour isnt all cognitive
Health isnt a motive

Habit, motives, environment


Emotion!

Private sector